Florida Power of Attorney

General Power of Attorney

Prepared by:

After Recording, Return to:

GENERAL POWER OF ATTORNEY

Finances and Property - Non-Durable

(Florida Statutes 709.2101 et seq.)

STATE OF FLORIDA

COUNTY OF

KNOW ALL ME BY THESE PRESENTS:

That I, , of , Florida, being of sound mind and memory, do hereby make, constitute and appoint as my true and lawful agent and attorney in fact.

This power of attorney grants broad authority over finances, property, business, banking, legal matters, and related transactions as described in the document.

The following powers are specifically granted to my attorney-in-fact (principal must initial any powers wished to be granted below):

(a) Create an inter vivos trust;

(b) Amend, modify, revoke, or terminate a trust, if expressly authorized by the trust instrument;

(c) Make a gift, subject to Florida Statutes 709.2202;

(d) Create or change rights of survivorship;

(e) Create or change a beneficiary designation;

(f) Waive right to be beneficiary of a joint and survivor annuity or retirement plan benefit;

(g) Disclaim property and powers of appointment;

(h) Conduct investment transactions as provided in section 709.2208(2), Florida Statutes;

(i) Conduct banking transactions as provided in section 709.2208(1), Florida Statutes;

Notwithstanding the foregoing, the attorney in fact may not:

1. Perform duties under a contract that requires the exercise of personal services of the principal;

2. Make any affidavit as to the personal knowledge of the principal;

3. Vote in any public election on behalf of the principal;

4. Execute or revoke any will or codicil for the principal;

5. Create, amend, modify, or revoke any document effective at the principal's death unless expressly authorized;

6. Exercise powers and authority granted to the principal as trustee or as court-appointed fiduciary.

I do hereby undertake to ratify and confirm, all and singular, the acts heretofore performed and to be hereinafter performed by my said agents, acting in my name and on my behalf.

IN WITNESS WHEREFORE, I have executed this General Power of Attorney consisting of pages this the day of , 20 .

ATTESTATION

The witnesses declare under penalty of perjury that the principal signed and acknowledged this power of attorney in their presence and that the principal appears to be of sound mind and under no duress, fraud or undue influence.

Witness our signatures, this the day of , 20 .

WITNESSES:

STATE OF FLORIDA

COUNTY OF

The foregoing instrument was acknowledged by me this day of , 20 by: who is/are personally known to me or who has/have produced as identification.